前列腺软斑病1例报告并文献复习  

Malakoplakia of the prostate:a case report and literature review

作　　者：张颖 许然 李思 罗广承[1,2] 王新君 Zhang Ying;Xu Ran;Li Si;Luo Guangcheng;Wang Xinjun(Department of Urology,Zhongshan Hospital of Xiamen University,School of Medicine,Xiamen University,Xiamen,Fujian 361004,China;The School of Clinical Medicine,Fujian Medical University,Fuzhou,Fujian 350122,China)

机构地区：[1]厦门大学附属中山医院泌尿外科,福建厦门361004 [2]福建医科大学临床医学部,福建福州350122

出　　处：《泌尿外科杂志（电子版）》2024年第3期72-78,共7页Journal of Urology for Clinicians(Electronic Version)

基　　金：福建省卫生计生委中青年人才培养项目(2021GGB028)。

摘　　要：软斑病是一种罕见的肉芽肿性炎症反应,特征为显微镜下呈嗜碱性同心层状Michaelis-Gutmann小体,其发生可能与大肠杆菌感染导致的巨噬细胞功能障碍有关。前列腺软斑病极为罕见,主要临床症状包括尿潴留、尿频、尿急、排尿困难、发热及夜尿增多,且还可能出现血尿,直肠检查和影像学检查结果与前列腺癌相似。前列腺穿刺活检是诊断的主要手段,治疗主要采用抗生素,必要时需进行手术。本文报告1例前列腺软斑病病例,根据其临床表现和磁共振成像结果,最初认为极有可能为前列腺癌,然而,前列腺活检发现为前列腺软斑病。患者反复出现发热、尿频、尿急、排尿困难、右侧睾丸肿胀等症状,经过常规抗生素治疗后,再次行前列腺穿刺活检术证实软斑病消失,达到痊愈。因此,建议此类患者进行尿液和血液培养检查,并根据药敏试验结果使用敏感抗生素治疗前列腺软斑病。Malakoplakia is a rare granulomatous inflammatory reaction characterized by concentrically laminated Michaelis-Gutmann bodies that are alkaliphilic under the microscope.Its occurrence may be related to macrophage dysfunction caused by escherichia coli infection.Malakoplakia in the prostate is extremely rare,and its main clinical symptoms include urinary retention,urinary frequency,urgency,dysuria,fever,and nocturia.It may also be complicated by hematuria,and its rectal examination and imaging findings are similar to those of prostate cancer.The biopsy is the main means of diagnosis,and treatment mainly involves antibiotics,with surgery performed as necessary.We report a case of prostatic malakoplakia,which was initially considered to be highly likely to be prostate cancer based on its clinical manifestations and magnetic resonance imaging.However,a prostate biopsy revealed Malakoplakia.The patient experienced recurrent fever,urinary frequency,urgency,dysuria,and right testicular swelling,and after regular antibiotic treatment,a prostate biopsy confirmed the disappearance of malakoplakia,achieving a cure.Therefore,we recommend urine and blood culture tests,and treatment of prostatic malakoplakia with sensitive antibiotics according to the results of drug sensitivity testing.

关 键 词：前列腺 软斑病 Michaelis-Gutmann小体 

分 类 号：R697.3[医药卫生—泌尿科学]